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Pronunciation |
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(goe
nad oh REL
in) |
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U.S. Brand
Names |
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Factrel®;
Lutrepulse® |
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Generic
Available |
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No |
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Synonyms |
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GnRH; Gonadorelin Acetate; Gonadorelin Hydrochloride; Gonadotropin Releasing
Hormone; LH-RH; LRH; Luteinizing Hormone Releasing Hormone |
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Pharmacological Index |
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Diagnostic Agent, Gonadotrophic Hormone; Gonadotropin |
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Use |
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Evaluation of the functional capacity and response of gonadotrophic hormones;
evaluate abnormal gonadotropin regulation as in precocious puberty and delayed
puberty. Lutrepulse®: Induction of ovulation in females
with hypothalamic amenorrhea. |
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Pregnancy Risk
Factor |
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B |
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Contraindications |
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Known hypersensitivity to gonadorelin, women with any condition that could be
exacerbated by pregnancy; patients who have ovarian cysts or causes of
anovulation other than those of hypothalamic origin; any condition that may
worsened by reproductive hormones |
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Warnings/Precautions |
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Hypersensitivity and anaphylactic reactions have occurred following
multiple-dose administration; multiple pregnancy is a possibility; use with
caution in women in whom pregnancy could worsen pre-existing conditions (eg,
pituitary prolactinemia). Multiple pregnancy is a possibility with
Lutrepulse®. |
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Adverse
Reactions |
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1% to 10%: Local: Pain at injection site
<1%: Flushing, lightheadedness, headache, rash, nausea, abdominal
discomfort |
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Overdosage/Toxicology |
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Symptoms of overdose include abdominal discomfort, nausea, headache, flushing
Treatment is symptomatic |
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Drug
Interactions |
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Decreased levels/effect: Oral contraceptives, digoxin, phenothiazines,
dopamine antagonists
Increased levels/effect: Androgens, estrogens, progestins, glucocorticoids,
spironolactone, levodopa |
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Stability |
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Factrel®: Prepare immediately prior to use; after
reconstitution, store at room temperature and use within 1 day; discard unused
portion
Lutrepulse®: Store at room temperature; reconstitute
with diluent immediately prior to use and transfer to plastic reservoir. The
solution will supply 90 minute pulsatile doses for 7 consecutive days
(Lutrepulse® pump). |
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Mechanism of
Action |
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Stimulates the release of luteinizing hormone (LH) from the anterior
pituitary gland |
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Pharmacodynamics/Kinetics |
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Peak effect: Maximal LH release occurs within 20 minutes
Duration of action: 3-5 hours
Half-life: 4 minutes |
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Usual Dosage |
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Diagnostic test: Children >12 years and Adults (female): I.V., S.C.
hydrochloride salt: 100 mcg administered in women during early phase of
menstrual cycle (day 1-7)
Primary hypothalamic amenorrhea: Female adults: Acetate: I.V.: 5 mcg every 90
minutes via Lutrepulse® pump kit at treatment intervals of
21 days (pump will pulsate every 90 minutes for 7 days) |
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Monitoring
Parameters |
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LH, FSH |
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Mental Health: Effects
on Mental Status |
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None reported |
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Mental Health:
Effects on Psychiatric
Treatment |
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Antipsychotics may decrease the effects of gonadorelin |
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Patient
Information |
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If receiving this drug via pulsating pump, check all procedures with
prescriber. Report any rash, pain, or inflammation at injection site, and any
change in respiratory status. |
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Nursing
Implications |
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Parenteral: Dilute in 3 mL of normal saline; administer I.V. push over 30
seconds |
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Dosage Forms |
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Injection, as acetate (Lutrepulse®): 0.8 mg, 3.2 mg
Injection, as hydrochloride (Factrel®): 100 mcg, 500
mcg |
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References |
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Pescovitz OH, Comite F, Hench K, et al,
"The NIH Experience With Precocious Puberty: Diagnostic Subgroups and Response to Short-Term Luteinizing Hormone-Releasing Hormone Analogue Therapy,"
J Pediatr, 1986, 108(1):47-54.
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